We will have Merrilee Severino with Younique cosmetics doing mini makeovers at the office today and we will have several items around the office for sale. Come look and see if something catches your eye and let Merrilee show you how you can have amazing lashes all naturally with no falsies! 5119 Commercial Way Springhill, FL 34606

Dr. Gorrell has accepted a contract to do anesthesia in Guam in the month of August 2015. Upon his return, he has accepted a position to join a fantastic group of Anesthesiologists in Kansas. In order to obtain your records, please call the office number 352-224-3139 and leave a message. You can also receive them thru the patient portal at Practice Fusion or send a release of information via fax to 888-972-3813. It has been our pleasure to serve the Hernando county community and hope you all remain on your wellness programs. You can continue to order supplements thru the website. Please contact your insurance company for a referral for another in network physician or call our office number for a list of names and telephone numbers for other physicians in the area.

Please join Merrilee Severino of The Gorrell Institute’s quest to equip, empower and educate women and young girls with safety!

Damsel in Defense is about equipping women and young ladies with the tools to not only keep them safe but also to give them the confidence to know that they have a way out if they ever feel threatened. We are very excited about our affordable and adorable line of products. Whether you are at home or traveling, running or celebrating downtown with the girls, Damsel in Defense has the products and fact-based education that can and does save lives.

A violent crime occurs every 26 seconds. 1 in 3 women experience domestic violence from their partners. 1 in 5 women are survivors of rape. A child is abducted every 40 seconds. College women are 4x more likely to be assaulted, but these numbers may be higher because not all attacks are reported. Don’t be a statistic, be prepared!

We extended the shopping link until 12pm this Friday, December 5th. For those who would like to order, call me at 352-587-1639 or go to my website at www.mydamselpro.net/liz and shop under her link. Don’t miss out on saving the $5 shipping fee by having your products shipped to your beautiful hostess, Merrilee!!! I’m available to answer any questions you may have. Don’t forget about the Safe & Sassy bundle special we have: purchase a stun gun and a keychain pepper spray and receive a FREE gift.
Please check out all of the products offered to see what you feel comfortable with. I am available to answer all questions.

www.mydamselpro.net/liz

If you were unable to attend on Tuesday, December 2nd and would still like to place and order:
How To Order: Follow the link to my website, click on “Shop Now” or “Shop Online” and shop under her party link. This Empower Hour will end at 12:00pm on Friday, December 5. Thank you.

All products legal in the State of Florida. Not all products are legal in all 50 states, the website indicates information under each product for states.

Dr. Gorrell has severed his relationship as designated physician with Fix All Medical Clinic (PMC748) effective July 31, 2014. He will continue to see any patients that may have been treated there on an emergency only basis. If patients are needing their medical records, they are to send a request to Kurt Shultz at Fix All Medical Clinic at 2123 West Dr Martin Luther King Jr Blvd Suite 201 Tampa, FL 33607. For patients needing treatment, they are to call The Gorrell Institute at 352-224-3139. Patients will need to have copies of their records and will be charged the rate of a follow up patient. The Gorrell Institute does accept Medicare, Simply Health Care Medicare and all Cigna Plans. If a patient does have a plan that we participate with, then applicable co-payments and deductibles will be collected.

Recently, we opened up our doors and invited the local pharmacists to come and visit our practice. We had three pharmacies take us up on our offer and stopped by. I would like to thank Cortez Drugs, Seven Hills Pharmacy, and Pinebrook Pharmacy for taking the time out of their day and coming to visit our office. We did this mostly because of patients that have complained that Walgreens had refused to fill their prescription(s) and inferred that it had something to do with Dr. Gorrell.

We came across and interesting article that reveals the selective process Walgreens has been using to choose whom they will fill and whom they will not fill for.

Dr. Gorrell is taking an innovative approach to the difficult and complex dynamic between pain management clinics/physicians and pharmacies/pharmacists. He has issued the invitation to pharmacies and their staff to come and visit his clinic open door style.

Dr. Gorrell is board certified in both anesthesia as well as pain management and exempt from the state requirement to register and be inspected, however he chooses to for quality assurance standards. He is now taking it one step further and opening his doors to local pharmacies. He will have an open door for pharmacists and their staff all day to tour the office and review his documents.

Since his move to Spring Hill in 2012, he has been working to develop rapport with local pharmacies because it is difficult for patients to find pain medication due to the pain medication shortage as well as the evolving rules and regulations that individual pharmacies have imposed. Dr. Gorrell will make available his forms and documents, his quality assurance manual, prior inspection reports, his curriculum vitae, criminal background report as well as a redacted patient record.

HIPAA Compliance Agreement
Effective Date:09/10/2013
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
If you have any questions about this notice, please contact Merrilee Severino, CPC, CMMP (352) 224-3139.
OUR OBLIGATIONS:
We are required by law to:
Maintain the privacy of protected health information
Give you this notice of our legal duties and privacy practices regarding health information about you
Follow the terms of our notice that is currently in effect
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION:
The following describes the ways we may use and disclose health information that identifies you (“Health Information”). Except for the purposes described below, we will use and disclose Health Information only with your written permission. You may revoke such permission at any time by writing to our practice Privacy Officer.
For Treatment. We may use and disclose Health Information for your treatment and to provide you with treatment-related health care services. For example, we may disclose Health Information to doctors, nurses, technicians, or other personnel, including people outside our office, who are involved in your medical care and need the information to provide you with medical care.
For Payment. We may use and disclose Health Information so that we or others may bill and receive payment from you, an insurance company or a third party for the treatment and services you received. For example, we may give your health plan information about you so that they will pay for your treatment.
For Health Care Operations. We may use and disclose Health Information for health care operations purposes. These uses and disclosures are necessary to make sure that all of our patients receive quality care and to operate and manage our office. For example, we may use and disclose information to make sure the obstetrical or gynecological care you receive is of the highest quality. We also may share information with other entities that have a relationship with you (for example, your health plan) for their health care operation activities.
Appointment Reminders, Treatment Alternatives and Health Related Benefits and Services. We may use and disclose Health Information to contact you to remind you that you have an appointment with us. We also may use and disclose Health Information to tell you about treatment alternatives or health-related benefits and services that may be of interest to you.
Individuals Involved in Your Care or Payment for Your Care. When appropriate, we may share Health Information with a person who is involved in your medical care or payment for your care, such as
your family or a close friend. We also may notify your family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort.
Research. Under certain circumstances, we may use and disclose Health Information for research. For example, a research project may involve comparing the health of patients who received one treatment to those who received another, for the same condition. Before we use or disclose Health Information for research, the project will go through a special approval process. Even without special approval, we may permit researchers to look at records to help them identify patients who may be included in their research project or for other similar purposes, as long as they do not remove or take a copy of any Health Information.
SPECIAL SITUATIONS:
As Required by Law. We will disclose Health Information when required to do so by international, federal, state or local law.
To Avert a Serious Threat to Health or Safety. We may use and disclose Health Information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Disclosures, however, will be made only to someone who may be able to help prevent the threat.
Business Associates. We may disclose Health Information to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, we may use another company to perform billing services on our behalf. All of our business associates are obligated to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.
Organ and Tissue Donation. If you are an organ donor, we may use or release Health Information to organizations that handle organ procurement or other entities engaged in procurement, banking or transportation of organs, eyes or tissues to facilitate organ, eye or tissue donation and transplantation.
Military and Veterans. If you are a member of the armed forces, we may release Health Information as required by military command authorities. We also may release Health Information to the appropriate foreign military authority if you are a member of a foreign military.
Workers’ Compensation. We may release Health Information for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Public Health Risks. We may disclose Health Information for public health activities. These activities generally include disclosures to prevent or control disease, injury or disability; report births and deaths; report child abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
Health Oversight Activities. We may disclose Health Information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Data Breach Notification Purposes. We may use or disclose your Protected Health Information to provide legally required notices of unauthorized access to or disclosure of your health information.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose Health Information in response to a court or administrative order. We also may disclose Health Information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement. We may release Health Information if asked by a law enforcement official if the information is: (1) in response to a court order, subpoena, warrant, summons or similar process; (2) limited information to identify or locate a suspect, fugitive, material witness, or missing person; (3) about the victim of a crime even if, under certain very limited circumstances, we are unable to obtain the person’s agreement; (4) about a death we believe may be the result of criminal conduct; (5) about criminal conduct on our premises; and (6) in an emergency to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
Coroners, Medical Examiners and Funeral Directors. We may release Health Information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We also may release Health Information to funeral directors as necessary for their duties.
National Security and Intelligence Activities. We may release Health Information to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law.
Protective Services for the President and Others. We may disclose Health Information to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or to conduct special investigations.
Inmates or Individuals in Custody. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release Health Information to the correctional institution or law enforcement official. This release would be if necessary: (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) the safety and security of the correctional institution.
USES AND DISCLOSURES THAT REQUIRE US TO GIVE YOU AN OPPORTUNITY TO OBJECT AND OPT
Individuals Involved in Your Care or Payment for Your Care. Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your Protected Health Information that directly relates to that person’s involvement in your health care., If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment.
Disaster Relief. We may disclose your Protected Health Information to disaster relief organizations that seek your Protected Health Information to coordinate your care, or notify family and friends of your location or condition in a disaster. We will provide you with an opportunity to agree or object to such a disclosure whenever we practically can do so.
YOUR WRITTEN AUTHORIZATION IS REQUIRED FOR OTHER USES AND DISCLOSURES
The following uses and disclosures of your Protected Health Information will be made only with your written authorization:
1. Uses and disclosures of Protected Health Information for marketing purposes; and
2. Disclosures that constitute a sale of your Protected Health Information
Other uses and disclosures of Protected Health Information not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you do give us an authorization, you may revoke it at any time by submitting a written revocation to our Privacy Officer and we will no longer disclose Protected Health Information under the authorization. But disclosure that we made in reliance on your authorization before you revoked it will not be affected by the revocation.
YOUR RIGHTS:
You have the following rights regarding Health Information we have about you:
Right to Inspect and Copy. You have a right to inspect and copy Health Information that may be used to make decisions about your care or payment for your care. This includes medical and billing records, other than psychotherapy notes. To inspect and copy this Health Information, you must make your request, in writing, to Merrilee Severino, CPC, CMMP (352) 224-3139. We have up to 30 days to make your Protected Health Information available to you and we may charge you a reasonable fee for the costs of copying, mailing or other supplies associated with your request. We may not charge you a fee if you need the information for a claim for benefits under the Social Security Act or any other state of federal needs-based benefit program. We may deny your request in certain limited circumstances. If we do deny your request, you have the right to have the denial reviewed by a licensed healthcare professional who was not directly involved in the denial of your request, and we will comply with the outcome of the review.
Right to an Electronic Copy of Electronic Medical Records. If your Protected Health Information is maintained in an electronic format (known as an electronic medical record or an electronic health record), you have the right to request that an electronic copy of your record be given to you or transmitted to another individual or entity. We will make every effort to provide access to your Protected Health Information in the form or format you request, if it is readily producible in such form or format. If the Protected Health Information is not readily producible in the form or format you request your record will be provided in either our standard electronic format or if you do not want this form or format, a readable hard copy form. We may charge you a reasonable, cost-based fee for the labor associated with transmitting the electronic medical record.
Right to Get Notice of a Breach. You have the right to be notified upon a breach of any of your unsecured Protected Health Information.
Right to Amend. If you feel that Health Information we have is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our office. To request an amendment, you must make your request, in writing, to Merrilee Severino, CPC, CMMP (352) 224-3139 .
Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we made of Health Information for purposes other than treatment, payment and health care operations or for which you provided written authorization. To request an accounting of disclosures, you must make your request, in writing, to Merrilee Severino, CPC, CMMP (352) 224-3139 .
Right to Request Restrictions. You have the right to request a restriction or limitation on the Health Information we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on the Health Information we disclose to someone involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not share information about a particular diagnosis or treatment with your spouse. To request a restriction, you must make your request, in writing, to Merrilee Severino, CPC, CMMP (352) 224-3139. We are not required to agree to your request unless you are asking us to restrict the use and disclosure of your Protected Health Information to a health plan for payment or health care operation purposes and such information you wish to restrict pertains solely to a health care item or service for which you have paid us “out-of-pocket” in full. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.
Out-of-Pocket-Payments. If you paid out-of-pocket (or in other words, you have requested that we not bill your health plan) in full for a specific item or service, you have the right to ask that your Protected Health Information with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and we will honor that request.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you by mail or at work. To request confidential communications, you must make your request, in writing, to Merrilee Severino, CPC, CMMP (352) 224-3139 . Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our web site, www.doctorgorrell.com. To obtain a paper copy of this notice, simply ask the receptionist.
CHANGES TO THIS NOTICE:
We reserve the right to change this notice and make the new notice apply to Health Information we already have as well as any information we receive in the future. We will post a copy of our current notice at our office. The notice will contain the effective date on the first page, in the top right-hand corner.
COMPLAINTS:
If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. To file a complaint with our office, contact Merrilee Severino, CPC, CMMP (352) 224-3139. All complaints must be made in writing. You will not be penalized for filing a complaint.
I have been offered a copy of the full Notice of Privacy Practices prior to signing this consent. Kelvin W Gorrell MD PA reserves the right to revise its Notice of Privacy Practices at any time and patients will be notified of any changes. As part of our Privacy Polices, Kelvin W Gorrell MD PA may call/mail/e-mail me at my home or office or any other designated location as required for TPO. The practice may leave a message on voicemail or in person in reference to any items that assist the practice in carrying out TPO, such as appointments, reminders, insurance items and any calls pertaining to my clinical care.

I have the right to request additional restrictions on how Kelvin W Gorrell MD PA discloses my Protected Health Information such as who can or can not receive it. List any restrictions below:

List Family members who may be informed about your health, treatment or payment.

List Family members who may only be informed in the event of an emergency:

____________________________________________________________________
Address and phone other than home you would like your communication to be received
(I am fully aware that a cell phone is not a secure line)

I have reviewed the Notice of Privacy Practices from Kelvin W Gorrell MD PA. By signing this form, I consent to allow Kelvin W Gorrell M D PA to use and disclose my Protected Healthcare Information as they deem necessary to carry out Healthcare Operations. I understand that I may revoke my consent at any time but it must be in writing and signed by both me and a representative of Kelvin W Gorrell M D PA. It is then only effective from that day forward.

We are always updating our Facebook page at https://www.facebook.com/thegorrellinstitute for tons of health tips and recipes for our TLS plan. We also have contests and giveaways for every 100th like. Please remember that messages sent thru any social media are not secure, so always call the office to communicate directly with us for confidentiality.

For a limited time only you can get a subscription to our Transitions Weight Loss website for only $24.95 and receive a bottle of CORE Fat and Carb Inhibitor included in the price!!

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